Tourniquet padding

ABSTRACT

Tourniquet padding and methods of its use with a tourniquet are provided. The tourniquet padding comprises a cover sheet with at least one surface having anti-slip properties, and can be made with and without a compressible padding material disposed on the cover sheet. The tourniquet padding has a length sufficient to be wrapped around a limb of a person, and a width wider than the tourniquet. The cover sheet can be gathered along the proximal edge to accommodate a range of circumferences of extremities, and include an elastic member for wrapping around the extremity. The surface of the cover sheet to be placed in contact with the skin can include one or more adhesive elements to provide an interrupted adhesive surface. The adhesive elements can comprise an adhesive material that is adherable to skin, or a frictionally adhesive material having anti-slip properties to maintain the padding device in place on the skin during use. The surface of the cover sheet can comprise a liquid-repellent material to protect the tourniquet from becoming wet or soiled during a medical procedure. In an embodiment of the tourniquet padding, a padding material is disposed on a cover sheet such that at least the distal edge portion of the cover sheet can be turned onto a tourniquet disposed on the padding material. In another embodiment, the cover sheet comprises an extension of material along the lower or distal edge having an adhesive surface that is applied to the skin, and a second layer that is turned proximally over the lower (distal) edge of the tourniquet to protect the tourniquet, and to keep it from slipping distally. 
     In use, the tourniquet padding is wrapped about an extremity, a tourniquet is positioned onto the padding material, and the distal edge portion of the cover sheet is turned onto the tourniquet and secured. The distal edge portion of the cover sheet can include perforations to divide it into sections. As the tourniquet inflates and deflates, the cover sheet overlying the tourniquet flexes to accommodate the change in thickness. The tourniquet padding maintains a blood pressure cuff or other tourniquet in place on a limb and prevents it from slipping down the extremity during use.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent applicationSer. No. 09/795,606, filed Feb. 28, 2001 now U.S. Pat. No. 6,537,298.

FIELD OF THE INVENTION

The present invention relates to disposable padding for use in themedical field, and more particularly to padding used in connection withblood pressure cuffs and other tourniquets.

BACKGROUND OF THE INVENTION

Tourniquets are used by orthopedists, anesthesiologists and othermedical practitioners to stop the flow of blood through an artery bycompression, and are typically placed proximally on an upper or lowerextremity such as the upper arm or thigh, and occasionally in a moredistal position such as on the calf. Inflatable tourniquet cuffs arecommonly used in the medical field, and include bladders that areinflated by compressed air, producing enough compression to occlude thearterial flow. For an orthopedist or other surgeon who does extremitysurgery, this achieves an avascular, or “non-bleeding,” dry surgicalfield. By stopping the flow of blood into the extremity, surgery can beperformed in that extremity distal to the tourniquet without bleeding.With the artery occluded, no blood flows into the surgical field and thesurgeon can perform surgery in what is temporarily an avascular area.

To completely stop the flow of blood, a tourniquet should be applied ashigh as possible into the axilla or “armpit” in an upper extremity, orinto the groin adjacent to the inguinal ligament located at the creasebetween the lower abdomen and the anterior, or front part of the top ofthe thigh. Such placement occludes the artery before it begins to divideinto its branches, and provides a surgeon with a large operative fieldfor elbow and knee surgery. A large area is needed in order to prep theskin adequately and to drape the area properly so that during surgery,if an incision needs to be extended, the surgeon does not need to cutthrough drapes to do so.

Tourniquets in the form of blood pressure cuffs, are also used byanesthesiologists to monitor blood pressure during surgical procedures,by nurses in intensive care units, by medical personnel in transitionalcare units, among others. A blood pressure cuff is often applied andleft on for an extended time period, i.e., several days. The cuff isapplied as high as possible on the upper extremity in order to moreeffectively occlude the artery before it branches and obtain a moreaccurate blood pressure measurement.

In use during a surgical procedure, a tourniquet is applied withcontinuous pressure for an extended period of time. In the use of ablood pressure cuff during a surgical procedure or in an intensive careor cardiac care unit, the cuff is automatically and repeatedly inflatedand deflated at about one to two minute intervals to monitor bloodpressure, and can be left on for several days. This adds up to numerouscompressions of the skin during a procedure or treatment period.

Tourniquets are commercially available and typically 2 to 6 inches widefor single bladder tourniquets and about 8 to 9 inches wide for doublebladder tourniquets (“Bier blocks”). A blood pressure cuff about 4inches wide is used most frequently by anesthesiologists. For an averagesize patient, a 4-inch wide tourniquet is used for upper extremitysurgery, while a 4- to 6-inch wide tourniquet is typically applied tothe thigh for surgeries on the lower extremities.

Tourniquets are generally supplied without padding, and some surgeonsand anesthesiologists use a tourniquet without padding underneath.However, this can result in injury to the skin caused by prolonged orintermittent pinching while the surgery is performed or when the bloodpressure tourniquet is inflated/deflated to monitor blood pressure.

To avoid skin irritation and damage to the outer layers of the skin bythe repeated compression, a soft padding material is typically wrappedaround the extremity and the tourniquet is applied over the wrappedmaterial. Typically, 3 to 4 layers of sheet wadding or cast padding suchas WEBRIL™ cotton padding (Kendall Company) are used under thetourniquet.

Although desirable, the use of padding under a tourniquet isproblematic. The diameter or circumference of the upper arm and thighdecreases from the proximal end (i.e., shoulder, hip) to the distal end(i.e., elbow, knee). In most people, the upper arm and thigh areconically shaped like an ice cream cone, being wider at the top andnarrowing toward the elbow or knee. This presents problems inmaintaining a tourniquet in a stationary position on the upper part ofthe arm or the upper part of the thigh. Although the cushioning effectof the padding is a plus, the padding tends to slip distally down theextremity during a procedure. This situation becomes more problematic asthe weight of the person increases and the distal part of the extremityis proportionately smaller than the proximal part. In addition, aheavier patient tends to have looser skin and subcutaneous tissues,requiring a higher amount of compression to occlude the artery forsurgery or to obtain blood pressure.

Slippage of a blood pressure cuff along a limb causes particularproblems for anesthesiologists and surgeons. For surgical procedures,the tourniquet cuff is applied to the upper arm and inflated, bloodpressure is recorded, and the cuff is then deflated. As this is repeatedover an extended time during the procedure, the cuff slips distally anda different part of the extremity becomes compressed. This change in thelocation where the blood pressure measurements are taken can result ininaccurate readings.

There have also been numerous complaints about tourniquet slippage downthe arm or thigh and causing problems with proper occlusion of theartery during surgical procedures. For a surgical operation performed onan elbow, knee, forearm, hand, calf or foot, as the tourniquet slipsdistally, compression decreases and compromises the surgical field withbleeding. In addition, the distal edge of the tourniquet is not sterile,and as the edge enters the surgical field, the potential forpost-operative infection increases. There have also been problems withthe tourniquet or cuff slipping off the underlying padding material ontothe skin, resulting in blisters where the skin had been pinched.

Another problem arises when the tourniquet is applied over severallayers of cast padding, and the limb is prepped with a wet surgicalscrub. An extremity is typically elevated while it is being prepped by ascrub nurse, and fluid that runs up the arm or leg wets the tourniquetand/or tourniquet padding. Most surgical preps include skin irritantsand are applied and then wiped or rinsed off the skin. Consequently,compression by a wet padding and prolonged contact with a pre-operativeskin prep can result in serious damage to the outer layers of the skin.

In addition, tourniquets that become soiled with blood or other fluidsare difficult to clean thoroughly and, in cases of AIDS and otherinfectious diseases, the contaminated tourniquet is usually discarded.With the cost of tourniquets at about $200 and higher, this cansignificantly increase the cost of a surgery or other medical procedure.

Therefore, it would be desirable to provide a padding that can be usedin connection with a blood pressure cuff and other tourniquets thatovercome the foregoing problems.

SUMMARY OF THE INVENTION

The present invention provides a tourniquet padding designed to dealwith the foregoing problems of anesthesiologists and surgeons who usetourniquets.

In one aspect, the invention provides a tourniquet padding for use witha tourniquet. In one embodiment, the tourniquet padding comprises acover sheet with at least one surface having anti-slip properties.Preferably, the tourniquet padding further includes a compressiblematerial disposed on a surface of the cover sheet.

In an embodiment of the tourniquet padding, the surface of the coversheet to be placed in contact with the skin comprises one or moreadhesive elements to provide an interrupted adhesive surface. Theadhesive elements can comprise an adhesive material that is adherable toskin such as a pressure-sensitive adhesive material, or a frictionallyadhesive material such as silicon rubber, latex rubber, or foamedpolyvinyl chloride, having anti-slip properties to maintain the paddingdevice in place on the skin. The tourniquet padding has a lengthsufficient to be wrapped around a limb of a person, and a width widerthan the tourniquet. The cover sheet can comprise an extension ofmaterial along the lower or distal edge having an adhesive surface thatis applied to the skin, and a second layer that is turned proximallyover the lower (distal) edge of the tourniquet to protect thetourniquet, and to keep it from slipping distally. In anotherembodiment, a compressible padding material is secured on one side of amaterial layer with the other side having one or more adhesive elementsdisposed thereon to provide a non-slip surface. A tourniquet is placedonto the tourniquet padding, and the distal edge of the material layeris turned onto the tourniquet and secured using an adhesive element. Thepresent tourniquet padding advantageously holds a blood pressure cuff orother tourniquet in place on a limb and prevents it from slipping downthe limb during use.

In yet another embodiment, the tourniquet padding comprises acompressible material disposed on a single- or multi-layer stretch clingpolymeric film. The tourniquet padding is wrapped around the extremity,with the film-side of the padding applied against the skin. The filmpossesses elongation properties, and a moderate to high level of clingto prevent slippage of the tourniquet padding along the extremity duringuse. The film layer can be formed from a polymeric resin having inherentcling performance properties, or a polymeric resin incorporating atackifying or cling agent. Additionally, adhesive elements can beapplied to the surface of the film layer to be applied to or disposedagainst the skin of the user.

The portion of the tourniquet padding to be turned proximally onto thetourniquet can include perforations or slits provided at suitableintervals (along the length) that allow it to be divided or split toaccommodate a range of sizes of tourniquets, and/or theinflation/deflation of the tourniquet during use. In another embodiment,the tourniquet padding may be crimped, pleated or otherwise gatheredalong a proximal edge to make it slightly elastic, in order toaccommodate extremities (arm/leg) of varying circumferences. An elasticmember can also be attached along the proximal edge portion to furthersecure the tourniquet padding to an extremity.

In a preferred embodiment, the tourniquet padding also includes a layerof plastic or other liquid-repellent material to cover the distal edgeand at least a portion of the outer surface of the cover sheet that isplaced against the skin. This protects the padding from becoming soakedby prep solutions and other liquids that are applied to the limb.

In another aspect, the invention provides methods for using thetourniquet padding with a blood pressure cuff or other tourniquet. Inone embodiment using a tourniquet padding having a contact surface withdiscrete adhesive areas, the tourniquet padding is wrapped around a limbof a person and the adhesive areas are applied to or disposed againstthe skin. A tourniquet is then positioned over the tourniquet paddingand wrapped around the limb such that the distal edge of the tourniquetpadding extends beyond the distal edge of the tourniquet. The coversheet of the tourniquet padding is adhered to or brought into frictionalcontact with the skin, and the distal edge portion is folded onto thetourniquet and secured in place, for example, by adhering it to thetourniquet, or by securing the distal edge portion to the proximal edgeportion of the cover sheet, among other methods. The distal edge portionof the cover sheet can include perforations or slits to separate theedge portion into sections that are folded onto the tourniquet. Thetourniquet can then be inflated and deflated as required by the medicalprocedure.

In another embodiment of the method, a tourniquet padding comprising astretch cling (non-slip) film layer with a compressible layer disposedthereon, is wrapped around an extremity with the film layer disposedagainst the skin. A tourniquet is placed onto the compressible layer,and wrapped about the extremity. The distal extension portion of thefilm layer is folded onto the tourniquet and secured in place. Thecontact of the non-slip film layer with the skin maintains thetourniquet padding and overlying tourniquet in place on the skin duringa procedure.

In yet another aspect, the invention provides a cover sheet useful inmaking a tourniquet padding as provided according to the invention. Thecover sheet is preferably made of a conformable material having at leastone surface that has non-skid properties that can be provided, forexample, by adhesive elements disposed on the surface, or by theproperties of the conformable material itself. The cover sheet canoptionally include perforations to separate the distal edge intosections or flaps. The width of the sheet is desirably wider than atourniquet such that at least a portion of the sheet along the distaledge may be folded onto the tourniquet when positioned on the coversheet. The cover sheet can comprise a variety of conformable materials,including, for example, a scrim reinforced material having fibers orfilaments that are preferably at least partially embedded in thematerial and interwoven in a grid pattern in an open mesh web.Optionally, the sheet can be gathered along the distal and/or proximaledge portions, and further include an elastic element extending alongthe edge.

In another embodiment of a cover sheet, the sheet can comprise anelongate sheet of conformable material such as a scrim reinforcedmaterial, that is folded into two or more layers, for example, two coversheets and one or more inner layers. Each of the cover sheets caninclude an adhesive element on the outer surface along a distal edge.One cover sheet can include one or more adhesive areas on the proximalouter surface. Another cover sheet can include perforations to separatethe distal edge into sections.

In another embodiment of a cover sheet, the sheet comprises a single- ormulti-layer stretch cling polymeric film, optionally with perforationsalong a distal edge to separate the edge portion into sections or flaps,and/or adhesive elements applied to a surface of the sheet to enhanceattachment of the cover sheet to a surface, e.g., skin.

In another aspect, the invention provides a kit comprising thetourniquet padding contained in packaging, optionally with other itemssuch as an adhesive element for securing the edge portions together, anadhesive element having a length sufficient to be wrapped around anextremity of a person, a tourniquet, instructions for its use with atourniquet, and non-latex gloves, for example.

BRIEF DESCRIPTION OF THE DRAWINGS

Preferred embodiments of the invention are described below withreference to the following accompanying drawings, which are forillustrative purposes only. Throughout the following views, thereference numerals will be used in the drawings, and the same referencenumerals will be used throughout the several views and in thedescription to indicate the same or like parts.

FIG. 1 is a front perspective view of an embodiment of a tourniquetpadding of the invention.

FIG. 1A is a fragmentary view of the tourniquet padding of FIG. 1showing the incorporation of slits in the cover sheet.

FIG. 2 is a rear perspective view of the tourniquet padding of FIG. 1.

FIG. 3 is a side view of the tourniquet padding of FIG. 1, taken alonglines 3-3.

FIG. 4 is a front perspective view of the tourniquet padding of FIG. 1with a tourniquet positioned thereon.

FIG. 5A is a side view of the tourniquet padding and tourniquet of FIG.4, taken along lines 5A-5A showing placement of a portion of thetourniquet padding onto the tourniquet.

FIG. 5B is a side view of the tourniquet padding and tourniquet of FIG.5A, showing the tourniquet inflated during use.

FIG. 6 is a front perspective view of another embodiment of a tourniquetpadding of the invention that includes a liquid-impermeable layer.

FIG. 7 is a rear perspective view of the tourniquet padding of FIG. 6.

FIG. 8 is a side view of the tourniquet padding of FIG. 6, taken alonglines 8-8.

FIG. 9 is a side view of another embodiment of the tourniquet padding ofFIG. 6, taken along lines 8-8, showing an extension of theliquid-impermeable layer.

FIG. 10 is a front perspective view of another embodiment of atourniquet padding of the invention showing the cover sheet attached toan inner sheet layer.

FIG. 11 is a side view of the tourniquet padding of FIG. 6, taken alonglines 11-11.

FIG. 12 is a front perspective view of another embodiment of atourniquet padding of the invention.

FIG. 13 is a rear perspective view of the tourniquet padding of FIG. 12.

FIG. 14 is a side view of the tourniquet padding of FIG. 12, taken alonglines 14-14.

FIGS. 15A-15B are front perspective views of another embodiment of atourniquet padding of the invention having a gathered proximal edge,with FIG. 15B showing the proximal edge of the padding extended.

FIGS. 16A-16B are rear perspective views of the tourniquet padding ofFIGS. 15A-15B, with FIG. 16B showing the proximal edge of the paddingextended.

FIGS. 17A-17E are views of the tourniquet padding of FIG. 1 atsequential steps of applying the tourniquet padding and a tourniquet onthe upper arm of a person.

FIG. 18 is a front view of another embodiment of a tourniquet padding ofthe invention having a single cover sheet with an overlying paddingmaterial attached thereto.

FIG. 18A is another embodiment of the tourniquet padding of FIG. 18,having fastening members (e.g., snaps) along the proximal edge portion.

FIGS. 19, 19A are rear views of the tourniquet padding of FIGS. 18, 18A,respectively.

FIG. 20 is a side view of the tourniquet padding of FIG. 18.

FIGS. 21A-21B are front views of embodiments of the tourniquet paddingof FIG. 18 with a tourniquet positioned thereon.

FIGS. 22A-22B are side views of the tourniquet padding and tourniquet ofFIGS. 21A-21B respectively taken along line 22A-22A, 22B-22B.

FIGS. 23A, 23B, 23C, 23D, 23E and 23F are partial front views of thetourniquet padding of FIG. 18 showing embodiments of an elastic elementattached to the cover sheet.

FIGS. 24 and 25 are end views of the cover sheets of FIGS. 23E and 23Ftaken respectively along line 24-24, 25-25.

FIG. 26 is a front view of an elongate adhesive element wrapped aroundthe upper arm of a person.

FIGS. 27A-27B are views of the tourniquet padding of FIG. 18 atsequential steps of applying the padding and a tourniquet onto the upperarm of a person.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention encompasses a tourniquet padding for use with atourniquet, and methods for making and using the tourniquet padding.

As used herein, the term “upper extremity” refers to the “arm” of aperson including the shoulder, arm, elbow, forearm, wrist and hand. Theterm “lower extremity” refers to the “leg” of the person including thehip, thigh, knee, calf, ankle and foot.

A first embodiment of a tourniquet padding 10 of the present inventionis described with reference to FIGS. 1-5. As shown, the tourniquetpadding 10 comprises a padding material 12 disposed between a first(outer) cover sheet 14 and a second (inner) cover sheet 16. As depicted,the cover sheets 14, 16 are formed from a unitary sheet that is foldedinto at least three overlying layers to form the two cover sheets andone or more inner sheets 17. The padding layer 12 is positioned betweenthe second cover sheet 16 and the inner sheet and provides a cushioningeffect. In any of the embodiments described herein, the cover sheets andinner sheets can also comprise separate, individual sheets (not shown)placed on opposite sides of the pad. In addition, the padding layer 12can be omitted, and the tourniquet padding can be used as an underlayerbeneath a tourniquet to maintain the tourniquet in place and prevent itfrom slipping down the extremity, and/or as a covering to keep thetourniquet clean.

Each of the cover sheets 14, 16, has an inner surface 18, 20, an outersurface 22, 24, a length 26, 28, a width 30, 32, a first side edge 34,36, a second side edge 38, 40, a distal edge 42, 44, and a proximal edge46, 48. In use, as further discussed below, the tourniquet padding 10 istypically wrapped around a limb such that the second (inner) cover sheet16 is applied against the skin 49 (FIGS. 5A-5B), and the distal edge 54of the padding is oriented in the direction of the distal portion of thelimb, i.e., the hand or foot. The proximal edge 56 of the tourniquetpadding 10 is then oriented toward the proximal end of the limb, i.e.,the shoulder or groin.

Referring to FIG. 1, the distal portion 58 of the first (outer) coversheet 14 is foldable along a fold line 60 at its distal edge 42. Thefirst cover sheet 14 can include scoring or indicia such as lining orarrows running longitudinally to indicate the fold line 60 (and wherethe inferior or distal edge of the tourniquet would be placed).

It is also desirable that the first cover sheet 14 includes perforations62, or slits 63 as shown in FIG. 1A, that are spaced apart at regularintervals along the length 26 of the distal edge 42, for separating thedistal edge into sections or flaps 64. In use, as shown in FIG. 4, thedistal portion 58 of the cover sheet 14 is turned proximally over atourniquet 65 positioned on the cover sheet 14 near the fold line 60.The perforations 62 or slits 63 allow the cover sheet 14 to separate andaccommodate the changing size (i.e., thickness) of the tourniquet 65 asit inflates and deflates. As depicted in FIGS. 5A-5B, the distal portion58 of the first (outer) cover sheet 14 lifts upward as the tourniquetinflates while the second (inner) cover sheet 16 remains secure to theskin 49. This arrangement advantageously avoids pulling on the secondcover sheet 16 and the underlying skin 49 so that there is little or noblistering of the skin as the tourniquet is inflated and deflated.

Referring to FIGS. 1-3, adhesive material is applied along the distaledges 42, 44 of the outer surfaces 22, 24 of the cover sheets 14, 16.The adhesive is applied as a strip or band 66, 68, along the length 26,28 of the cover sheets, and can be in the form of a solid band,intermittent lines, dots or other discrete or disconnected segments, andthe like. The strip of adhesive 66 along the edge 42 of the first coversheet 14 is typically about 0.5 to about 1 inch wide, and sufficient tosecurely adhere the distal portion 58 of the first cover sheet 14 on thesurface of a tourniquet 65 and maintain the tourniquet in position onthe padding 10 during use. Although not shown, the proximal surface area70 of the first (outer) cover sheet 14 can further comprise a solidlayer or lines or other discrete areas of adhesive to hold thetourniquet in place on the cover sheet 14 during use.

As depicted in FIG. 2, the second (inner) cover sheet 16 includes astrip of adhesive 68 along the distal edge 44, and one or more discreteareas 72 of adhesive such as oblique/vertical strips and/or spots orspaced apart areas arranged over its proximal surface area 74. The stripof adhesive strip 68 and the adhesive areas 72 are sufficient to adherethe tourniquet padding 10 to the skin 49, and inhibit the padding andtourniquet from slipping along a limb during use. The strip of adhesive68 is typically about 0.5 to about 1 inch wide. It is preferred thatadhesive is not applied as a solid layer over the proximal surface area72 of the second cover sheet 16 because, as the tourniquet is inflated,it would pinch the skin as the circumference of the extremity isdecreased in size by compression of the tourniquet. The strip ofadhesive 68 along the distal edge 44 of the cover sheet can comprise asolid band of adhesive because that section of the tourniquet padding isnot compressed during inflation of the tourniquet.

The adhesive material that is used in conjunction with the tourniquetpadding, particularly on the second (inner) cover sheet 14 that isplaced against the skin, is preferably a biocompatible andhypoallergenic adhesive material that is adherable to skin but willrelease from the skin with minimal trauma. Such adhesives are well knownin the art and commercially available. Useful adhesives include, forexample, acrylic adhesives that are used in surgical applications wherereduced skin trauma is required. Preferably, the adhesive is apressure-sensitive adhesive substance.

In another embodiment, the adhesive strip 68 and adhesive areas 72comprise a frictionally adhesive material having anti-slip properties,as, for example, latex rubber, silicon rubber, or foamed polyvinylchloride, with a typical thickness of about 0.001 to about 0.5 mm. Suchmaterials are described for example, in connection with anti-slip socksused in hospitals, hotels, and the like, non-slip garments, and non-slipmats, such as in U.S. Pat. No. 6,332,825 (Henrickson), U.S. Pat. No.6,041,443 (Pas et al.), U.S. Pat. No. 6,022,617 (Calkins), and U.S. Pat.No. 5,901,706 (Griesbach et al.), the disclosures of which areincorporated by reference herein. The anti-slip material can be appliedas a coating to the surface 74 of the cover sheet 16 in a dot, grid, orsuitably designed pattern, to effect suitable surface resistance of thecover sheet 16 on the skin. Suitable coating methods for applying theanti-slip material include, for example, solution coating, gravurecoating, and print coating, among others. The anti-slip material can bepigmented if desired. The anti-slip material provides frictionaladhesion to reduce slippage of the tourniquet padding during use.

As shown in FIG. 3, it is also desirable that the adhesive surfaces areprotected by a suitable removable covering or releasably attachedrelease or slip sheet 76 a-b. For example, a release sheet 76 a can beapplied as a cover over the entire surface of the cover sheet, as alongitudinal strip 76 b over the adhesive band 66 along the edge 42 ofthe cover sheet 14, or a panel section (not shown) over the proximalsurface areas 70, 74 of the cover sheets, and combinations thereof. Therelease sheets 76 a, 76 b can then be peeled off just prior to applyingthe tourniquet padding to the limb. In an embodiment in which the firstcover sheet 14 includes slits 63, as depicted in FIG. 1A, an overlyingpeel-off layer 76 b placed over the adhesive 66 can serve to maintainthe sections 64 in place before being applied to the tourniquet.

The cover sheets 14, 16 provide a flexible yet strong covering over theinner padding 12, and can be manufactured from any suitably compliant,natural or synthetic (man-made) material including but not limited to,paper, scrim reinforced tissue or other reinforced scrim material,crepe, cloth, terry cloth, cheesecloth, plastic (polymer film), and thelike, and combinations thereof. Also useful are non-woven fabrics suchas felt (carded non-woven) made from polyester, rayon or other fiber, orabsorbent web (airlaid non-woven) made from wood pulp or syntheticfibers typically used for diapers, baby wipes, sanitary towels, drapesand gowns, among other products. The cover sheet can be fabricated as alaminate, for example, a laminate of tissue and a non-woven or wovensubstrate, a laminate of a polymer film (e.g., polyethylene) backing andnon-woven or woven substrate material such as a tissue/poly laminatesimilar to that used for dental bibs and table coverings, a polyurethanefoam-polymer film laminate (thermo- or adhesively laminated) similar tothat used for EMS blankets, and the like. Preferably, the cover sheetsare composed of a material that is porous (breathable) to pass moisture,vapor and air.

A preferred material comprises a lightweight conformable scrimreinforced material that allows the tourniquet padding to readily flexand bend about the extremity. Scrim reinforced materials are well knownand widely used, and comprise threads or filaments. Preferably, thescrim fibers or strands are embedded or partially embedded in thematerial, and are preferably interwoven at about right angles in an openmesh web or grid. Suitable scrims can be made from paper, knits, wovens,non-wovens and extruded porous sheets such as materials available fromConweb, Minneapolis, Minn. Examples of suitable scrim filaments includefiberglass and ceramic fibers, and fibers made of polyester,polyethylene and other polyolefins, polyacrylate, rayon, cotton, hemp,jute, natural rubber, polyurethane, and blends thereof. Scrim materialsare also described, for example, in U.S. Pat. Nos. 6,027,465, 6,100,206,and 6,132,835 (Scholz et al., 3-M Company), the disclosures of which areherein incorporated by reference.

The padding layer 12 provides a cushioning sufficient to prevent theskin of a person from being pinched by a tourniquet 65 mounted on thetourniquet padding 10 and wrapped around a limb of the person.Typically, as shown, no padding is provided in the distal portions 58,59 of the cover sheets 14, 16. The padding 12 can comprise a porous ornon-porous material, or a natural or synthetic fiber material. Adesirable padding material is cast padding, which can be made fromcotton, nylon, rayon, acrylic, polyester, and other like materials andblends. Other suitable materials include a paper material, a scrimreinforced material, a foamed material such as a polyurethane foam, orother material having memory that will return to its pre-compressedshape after being compressed, and combinations thereof.

Preferably, the materials used in making the tourniquet padding aresterilizable. As such, the tourniquet padding can be sterilized andpackaged to provide a clean surface along the edge of a surgical fieldadjacent the tourniquet.

In assembling the cover sheets 14, 16 and the padding layer 12, it isdesirable to bond the padding layer to at least the second cover sheet16, as depicted by the adhesive area 78 in FIG. 3. The padding can beattached to the cover sheet(s), for example, with an adhesive, bystitching and/or by thermal bonding. Optionally, but preferably, atleast a portion of the inner surface of the first (upper) cover sheet(proximal to the fold line) is bonded to the inner layer, for example byadhesive areas 80, as shown in FIG. 3. Adhesive is then applied onto theouter surfaces of each cover sheet along the distal edge and onto one ormore areas of on the outer surface of the second cover sheet, and acover sheet is applied over the adhesive areas.

The tourniquet padding 10 can optionally include a member 82 such as anadhesive tab attached at either or both of the side edges 14, 16 forsecuring the end of the tourniquet padding 10 together around the limb.

The length 50 of the tourniquet padding 10 is sufficient to allow thepadding to be wrapped around the limb, with the side edges 34/36, 38/40of the cover sheets 14, 16 meeting up or overlapping. Since the length50 that is needed will vary according to the application, it isdesirable to provide the tourniquet padding in rolls. Typically, for anadult, the tourniquet padding 10 ranges between approximately 8 inchesto approximately 26 inches in length. The padding 10 can be cut from theroll to a desired length, or can include perforations 84 at intermittentlocations along the length, as shown in FIGS. 1-2, which extend throughthe cover sheets 14, 16 and padding 12 to allow the tourniquet padding10 to be separated into sections.

Tourniquets vary in width and are generally available in widths of 2, 4or 6 inches. Dual bladder (“Bier blocks”) and other specializedtourniquets can be, for example, 8 to 9 inches in width. In the use of aBier block tourniquet, the proximal bladder is inflated, a localanesthetic is injected into a vein, and the arm is elevated to cause theanesthetic to migrate proximally to the edge of the proximal tourniquet,which produces numbness in the extremity. The second tourniquet isinflated over an anesthetic area of the arm, and the proximal tourniquetis deflated. This arrangement substantially eliminates tourniquet pain.

The width 52 of the tourniquet padding 10 can be varied to accommodatethe width 86 of the tourniquet 65. In general, the width 52 of thetourniquet padding is sufficient to receive a tourniquet thereon suchthat there is no or a minimal amount of contact of the tourniquet withthe skin in order to minimize pinching of the skin during theinflation/deflation of the tourniquet, and/or trauma to the skin fromcontact of the proximal edge of the tourniquet.

Referring to FIGS. 4 and 5A-5B, in use, a tourniquet 65 is positioned onthe tourniquet padding 10 such that the distal portion 58 of the first(outer) cover sheet 14 may be folded over at least a portion of thetourniquet. Preferably, the tourniquet padding 10 is wider than thetourniquet such that when the first cover sheet 14 is folded onto thetourniquet, the proximal edge 56 of the tourniquet padding extendsbeyond the proximal edge 88 of the tourniquet. For example, in the useof a tourniquet 65 that is about 4 inches wide, the tourniquet paddingis preferably at least about 5½ inches wide so that, in positioning thetourniquet on the padding, at least about ½-inch of the tourniquetpadding extends beyond the proximal edge 88 of the tourniquet, and atleast about 1-inch of the tourniquet padding extends beyond the distaledge 90 of the tourniquet. In addition, either cover sheet can be aswide or wider than the other cover sheet.

Referring now to FIGS. 6-8, in another embodiment of a tourniquetpadding 10′ according to the invention, the surfaces directed “down” theextremity (distally) are made to be waterproof, so that the prepping andother solutions used in surgery are not absorbed and/or wicked into thetourniquet padding positioned underneath the tourniquet. As depicted, alayer 92′ of a liquid-repellent material has been bonded to the surface94′ of the inner sheet 17′ and extends over the distal edge 44′ and ontoat least a portion of the outer surface 24′ of the second (inner) coversheet 16′. Suitable liquid-repellent materials include those that repeland/or are impermeable or impervious to liquids, including, for example,polyethylene or other plastic sheeting material. As shown in FIG. 8, theadhesive layer 68′ along the distal edge 44′ on the outer surface 24′ ofthe second cover sheet 16′ is then applied onto the plastic sheeting92′.

The portion of the first (upper) cover sheet applied to the tourniquethelps protects at least the distal edge of the tourniquet fromextraneous liquids and other materials that can soil the tourniquet. Tothat end, as depicted in FIG. 9, it is preferred that theliquid-repellent layer 92″ is applied to the first inner surface 18″ ofthe first cover sheet 14″. When the distal portion 58″ of the firstcover sheet 14″ is adhered onto the tourniquet, the plastic sheeting 92″will provide a protective covering for at least the distal edge of thetourniquet. More complete coverage of the surface of the tourniquet canbe achieved by widening the first cover sheet 14″ and attaching thedistal portion 58″ at or near the proximal edge of the tourniquet.

Although not shown, a liquid-repellent layer can be bonded only to thecover sheet, for example, the inner surface (18′) of the first (upper)cover sheet and/or the inner surface (20′) of the second (inner) coversheet, and not over the distal edges (42′, 44′) to make only thesurfaces of the cover sheets waterproof.

Another embodiment of a tourniquet padding 10′″ according to theinvention is shown in FIGS. 10-11. The tourniquet padding comprises aunitary sheet that is folded into at least two layers to form the second(inner) cover sheet 16′″ and at least one overlying (inner) layer 17′″.A padding material 12′″ is disposed between and attached by adhesiveareas 78″ to the inner layer 17′″ and the second cover sheet 16′″. Thefirst (outer) cover sheet 14′″ is attached to the surface 94′″ of theinner layer 17′″. As also shown, a liquid-impermeable sheet 92′″ isaffixed to the inner surface 18′″ of the first cover sheet 14′″ toprotect the surface of the tourniquet during a procedure. Aliquid-impermeable sheet 92′″ is also shown affixed to the surface 94′″of the inner layer 17′″, and extends over the distal edge 54′″ of thetourniquet padding and onto the outer surface 24′″ of the second coversheet to protect the padding material 12′″ from becoming wet.

Yet another embodiment of a tourniquet padding 10″″ according to theinvention is shown in FIGS. 12-14. As depicted, the cover sheets 14″″,16″″ are shown as a unitary sheet that is folded in about half with thepadding material 12″″ sandwiched therebetween. The padding layer 12″″ ispositioned between and affixed to the second (lower) cover layer 16″″,for example by an adhesive bonding 78″″. A portion of the inner surface18″″ of the first (upper) cover sheet 14″″ (proximal to the fold line60″″) is also shown as bonded to the padding layer 12″″ by adhesive area80″″.

The tourniquet padding can also have an element of elasticity toaccommodate its application to a range of sizes of extremities havingvarying circumferences. For example, in another embodiment, the coversheets of the tourniquet padding may be gathered to make it slightlyelastic in order to accommodate extremities (arm/leg) of varyingdiameter or circumference. As depicted in FIGS. 15A-16A, the coversheets 14 ^(v), 16 ^(v) of the tourniquet padding 10 ^(v) are pleated orcrimped (corrugated) along the proximal edge 56 ^(v). When thetourniquet padding is then wrapped around a limb of a person, the coversheets may be spread/extended along the proximal edge, as shown by thearrows in FIGS. 15B-16B, to wrap around a portion of the limb having awider circumference than at the distal edge 54 ^(v) of the tourniquetpadding.

A use of the tourniquet padding 10 depicted in FIGS. 1-5 is shown inFIGS. 17A-17E. The releasable sheet 76 a is first removed from theadhesive strip 68 and adhesive areas 72 on the second (inner) coversheet 14. As shown in FIGS. 17A-17B, the tourniquet padding 10 is thenwrapped around the limb 96 of the person, shown as the upper extremity,preferably with the ends 57 a, 57 b slightly overlapping, and theadhesive areas 68, 72 on the second cover sheet 16 are secured to theskin 49. A tourniquet 65 is then wrapped around the tourniquet padding10 such that the distal edge 90 of the tourniquet is at or near the foldline 60 of the first cover sheet 14. As shown in FIG. 17C, the distaledge portions 58, 59 of the first and second cover sheets 14, 16 extendbeyond the distal edge 90 of the tourniquet. The proximal edge 56 of thetourniquet padding also extends beyond the proximal edge 88 of thetourniquet.

As depicted in FIG. 17D, the distal portion 58 of the first cover sheet14 is then turned proximally over the lower or distal edge 90 of thetourniquet 65, and adhered to the tourniquet by means of the adhesive66. This keeps the tourniquet from slipping down the arm/leg, protectsit from fluids used for prepping the skin, and generally keeps thetourniquet clean. As depicted, the distal portion 58 has been separatedinto sections or flaps 64 by means of the perforated lines 62. As shownin FIG. 17E, the tourniquet 65 is thus securely positioned over thetourniquet padding 10 around the limb 96 of the user, and can beinflated and deflated with no or minimal slipping down the limb of theperson.

In the use of the tourniquet padding depicted in FIGS. 6-9, theinclusion of a liquid-impermeable layer 92″ in the design of the devicehelps prevent liquids that may be applied to the limb from coming intocontact with the padding. Referring to FIG. 17E, the adherence of thedistal portion 59 of the second (inner) cover sheet 16 to the skin andthe presence of a liquid-impermeable layer (not shown) over the distaledge 54 of the tourniquet padding substantially prevents liquid fromcontacting the portion of the padding underlying the tourniquet 65.

Another embodiment of a tourniquet padding 10 ^(a) is depicted in FIGS.18-22. The tourniquet padding comprises a single cover sheet 14 ^(a)with a compressible material layer 12 ^(a) disposed thereon. The paddinglayer 12 ^(a) is positioned on the film coversheet 14 ^(a) such that adistal portion (flap) 58 ^(a) and a proximal portion (flap) 98 ^(a) areprovided. Adhesive elements 72 ^(a) as described for tourniquet padding10, can be optionally disposed on the skin-side surface of the coversheet 14 ^(a). The width 100 ^(a) of the distal flap portion 58 ^(a)and/or the width 102 ^(a) of the proximal flap portion 98 ^(a) allowseither or both flaps to be folded completely over the tourniquet 65 ^(a)positioned on the padding 12 ^(a) to cover the tourniquet as depicted,for example, in FIGS. 21A-B, 22A-B. As shown in FIGS. 21A/22A, the flapportions 58 ^(a), 98 ^(a) have been folded onto the tourniquet 65 ^(a)with the ends overlapping. Optionally, one or more adhesive elements 82^(a) such as adhesive paste, two-sided tape, or tab (as shown), can beused to secure the overlapping flaps 58 ^(a), 98 ^(a) of the cover sheet14 ^(a). As another option, an adhesive element 82 ^(a) (e.g., adhesivepaste, two-sided tape, etc.), can be used to secure the ends of theflaps 58 ^(a), 98 ^(a) together, as shown in FIGS. 21B/22B.

In addition to the embodiments shown in FIGS. 15-16, to add an elementof elasticity to the cover sheet, the flap portions 58 ^(a) and/or 98^(a) can be pleated, crimped, corrugated, or otherwise gathered orbunched together along the edges 104 ^(a), 106 ^(a), using knowntechniques in the art (e.g., fluting or corrugating laminator).Additionally, an elastic element 108 ^(a) such as an elastic band orstrip, can be affixed to the cover sheet, such as depicted in FIGS. 23Aand 23B, by attaching it by means of anchor stitches 110 ^(a) (e.g.,stay stitches, surge stitches, etc.), by passing the elastic element 108^(a) through the cover sheet material directly (FIG. 23C) or throughslits or openings 112 ^(a) (FIG. 23D), or by another known means ofattachment. Referring to FIGS. 23E-F, 24 and 25 where the cover sheet 14^(a) is pleated or crimped, an elastic element 108 ^(a) can be anchored,for example, by adhesive or by stitching 110 ^(a) or other likeattachment means. In use, when the tourniquet padding 10 ^(a) is wrappedaround an extremity, the elastic element 108 ^(a) is stretched (arrow114 ^(a)) to provide an elasticized (expandable) band about theextremity and more securely maintain the padding in place on theextremity. Although not shown, an elastic element 108 ^(a) can also beused with the embodiments depicted in FIGS. 15-16.

To further enhance the attachment of the various embodiments of thetourniquet padding of the invention, a double-sided adhesive strip orband 116 ^(a) (having a removable slip liner disposed on either side ofthe strip) can be utilized. As depicted in FIG. 26, the adhesive strip116 ^(a) can be provided separately, the slip liner removed from a firstside of the strip, and the strip 116 ^(a) wrapped about and applied tothe extremity 49 ^(a). The slip liner can then be removed from thesecond side of the strip, and the tourniquet padding then wrapped aroundthe extremity over the adhesive strip 116 ^(a), as in FIGS. 17A, 27A.The adhesive strip 116 ^(a) can also be attached at an end 118 ^(a), 120^(a) (FIG. 19) or along the length (26, FIG. 1) to the outer side 24^(a) (skin side) of the cover sheet 14 ^(a) of the tourniquet padding.The adhesive band 116 ^(a) can comprise a frictionally adhesivematerial, a pressure sensitive adhesive material, and the like.

In yet another embodiment shown in FIGS. 18A-19A, mating fasteningmembers 122 ^(a′) such as male/female snaps and the like, can be affixedalong the proximal edge portion 56 ^(a′) of the cover sheet 14 ^(a′). Assuch, when the tourniquet padding 10 ^(a′) is wrapped around anextremity, the fastening members can be joined to maintain a snug fit ofthe padding 10 ^(a′). A series of fasteners can be used along one sideto accommodate a range of circumferences of the various extremities towhich the padding is applied.

The cover sheet 14 ^(a) of the tourniquet padding 10 ^(a) can comprise amaterial as described with respect to cover sheets 14, 16. In anotherembodiment, the cover sheet 14 ^(a) comprises a polymeric film layerhaving anti-slip (cling) properties, strength, and elongation and memoryproperties such that the film layer will cling to skin and preventslippage of a tourniquet disposed on the tourniquet padding during useon an extremity of a patient. The cover sheet 14 ^(a) can comprise asingle or multiple polymeric layers. At least one outside layercomprises a polymeric material having a moderate to high amount ofcling. Desirably, the film cover layer 14 ^(a) is a breathable film thatallows the passage of vapor and gas there through. Breathable films areknown in the art, and can be produced by any known method.

Examples of suitable polymer resins having inherent anti-slip propertiesfor cling use include polyethylene and polyethylene-containing films,including conventional linear low density polyethylene (LDPE), very lowdensity polyethylene (VLDPE), and ultralow density polyethylene (ULDPE)resins, which are homopolymers, copolymers or terpolymers of ethyleneand á-olefins such as propylene, 1-butene, 1-pentene, 1-hexene,4-methyl-1-pentene, and 1-octene. Such polyethylene resins are known inthe art, as described, for example, in U.S. Pat. No. 6,265,055 (Simpsonet al.) and U.S. Pat. No. 6,171,681 (Mascarenhas et al.), thedisclosures of which are incorporated by reference herein, and availablecommercially from a variety of sources, including, for example DOWLEX,AFFINITY, and ATTANE ethylene-1-octene copolymers (The Dow ChemicalCo.), among others.

Tackifying or cling agents, as known in the art, can be added to thepolymer resin mixture to provide or increase the cling of the coversheet film layer 14 ^(a). Examples of cling agents include hydrocarbonresins such as terpene resin, hydrogenated rosins, and rosin esters,atactic polypropylenes, polybutenes, polybutadiene, polyisobutylene, andthe like. Such agents are described, for example, in U.S. Pat. No.6,265,055 (Simpson et al.) and the patents cited therein (e.g., U.S.Pat. No. 5,922,441), the disclosures of which are incorporated byreference herein. Using a cling agent requires preblending orincorporating the agent into the resin material, and aging or theinclusion of an auxiliary component (e.g., alkali metal stearates,monoesters of fatty acids and polyols, such as glycerol mono-oleate or asorbitan ester) to convey the cling agent to the film surface. Otherdisclosed cling agents include copolymers of ethylene and functionalcopolymers such as acrylates and vinyl acetate (U.S. Pat. No. 6,265,055and cited patents, e.g., U.S. Pat. No. 5,212,001).

The cling film layer 14 ^(a) can be combined with additional layerscomprising a different polymer resin to provide mechanical strength andstretchability. For example, in a multi-layered construction, the sheetcan comprise, for example, one or more outer layers of a highlystretchable cling film having a high amount of memory, and one or moreinner or core layers of a low to moderate stretch film having acomparatively lower amount of memory.

The cling film 14 ^(a) can also include one or more known and compatibleadditives. Examples of such additives include slip agents (e.g., oleicamide, stearic amide), anti-blocking agents (e.g., inorganic substancesuch as silica and talc) to reduce blocking when the films are wound upon reels, and allow smooth unwinding from the reels, antioxidants,pigments, colorants, and processing aids.

The film layer 14 ^(a) is typically a blown film or cast film formed bya conventional extrusion process, or composite formed by a laminationprocess. Preferably, the gauge of the film is at least about 0.5 mil,preferably at least about 1 mil, up to about 3 mils, and is typicallyabout 0.5 mil to about 2 mils.

To form the tourniquet padding 10 ^(a) comprising a polymeric film coverlayer 14 ^(a), the film layer can be thermally bonded to a surface of acompressible padding layer 12 ^(a), for example, by conveying the filmlayer and padding layer as a sandwich through a series of heaters androlls that press the layers together to form a laminate. The film layer14 ^(a) can also be adhesively bonded to the padding layer 12 ^(a), forexample, using a pressure sensitive adhesive.

Optionally, adhesive elements 72 ^(a) can be affixed to the surface ofthe film layer 14 ^(a) to enhance the anti-slip properties of the filmon the skin.

As depicted in FIG. 20, a slip sheet or liner 76 ^(a) can be placed incontact with either surface of the tourniquet padding 10 ^(a) to protectthe exposed surface of the cover sheet 14 ^(a) and to serve to preventblocking of the padding 10 ^(a) when in roll form. An example of auseful slip liner is a polycoated paper (coated with high density,moderate density, or low density polyethylene). The slip sheet 76 ^(a)is removed prior to placement of the tourniquet padding 10 ^(a) on theskin.

In use of the tourniquet padding 10 ^(a) (FIGS. 18-20), the slip sheet76 ^(a) (if used) is removed, and the tourniquet padding 10 ^(a) iswrapped about the limb, similar to that depicted in FIG. 17A, with thepadding material 12 ^(a) facing outward and the second surface of thecover sheet 14 ^(a) placed against the skin. As shown in FIG. 27A, thetourniquet 65 ^(a) is positioned on the padding 12 ^(a) and wrappedabout the extremity (arrows 124 ^(a)). As depicted, the cover sheet 14^(a) can then be folded onto the tourniquet 65 ^(a) (arrows 126 ^(a)) byturning the proximal flap portion 98 ^(a) up onto the tourniquet 65^(a), and the distal flap portion 58 ^(a) folded onto the proximalportion 98 ^(a) as shown in FIG. 27B (or vice versa). If desired, one ormore adhesive elements 82 ^(a) can be used to secure the ends of thecover sheet 14 ^(a) over the tourniquet 65 ^(a).

In the use of a tourniquet padding 10 ^(a) utilizing a cling film coversheet 14 ^(a), the film side of the padding 10 ^(a) is applied to theskin, a tourniquet 65 ^(a) positioned onto the padding 12 ^(a), and theflap portions 58 ^(a), 98 ^(a) are folded onto the tourniquet 65 ^(a)with the ends overlapping, preferably in a self-adhering connection dueto the cling properties of the film. Optionally, one or more adhesiveelements 82 ^(a) can be used to secure the flaps 58 ^(a), 98 ^(a) of thecover sheet 14 ^(a).

The invention has been described by reference to detailed examples andmethodologies. These examples are not meant to limit the scope of theinvention. It should be understood that variations and modifications maybe made while remaining within the spirit and scope of the invention,and the invention is not to be construed as limited to the specificembodiments shown in the drawings.

1. A tourniquet padding, comprising: a single unitary cover sheet havingan inner surface, an outer surface, a length, opposing edges along thelength, and a plurality of discrete and spaced apart adhesive elementshaving anti-slip properties situated on the outer surface of the coversheet; and a padding material situated on a portion of the inner surfaceof the cover sheet and extending the length of the cover sheet betweensaid opposing edges, the padding material having a length and widthsized for receiving a tourniquet thereon, and the cover sheet extendingthe length of the padding material; and the cover sheet having a widthsufficient such that with the tourniquet situated over the paddingmaterial, the cover sheet can be placed to substantially cover thetourniquet.
 2. The tourniquet padding of claim 1, wherein the adhesiveelements are frictionally adhesive.
 3. The tourniquet padding of claim2, wherein the adhesive elements comprise a material selected from thegroup consisting of latex rubber, silicon rubber, and polyvinylchloride.
 4. The tourniquet padding of claim 1, wherein the adhesiveelements comprise a biocompatible adhesive material that is adherable toskin.
 5. The tourniquet padding of claim 1, further comprising a slipsheet releasably attached to the adhesive elements on the cover sheet.6. The tourniquet padding of claim 1, wherein the length of the coversheet is sufficient to be wrapped around an extremity of a person. 7.The tourniquet padding of claim 1, wherein the cover sheet comprises anon-woven material.
 8. The tourniquet padding of claim 1, wherein thecover sheet comprises a material selected from the group consisting ofpaper, reinforced scrim material, crepe, cloth, terry cloth,cheesecloth, plastic, and combinations thereof.
 9. The tourniquetpadding of claim 1, wherein the cover sheet comprises a polymer filmmaterial.
 10. The tourniquet padding of claim 1, wherein the cover sheetcomprises a stretch cling plastic material.
 11. The tourniquet paddingof claim 1, wherein the cover sheet comprises a laminate selected fromthe group consisting of a laminate of tissue and a non-woven material, alaminate of tissue and a woven material, a laminate of a polymer filmand a non-woven or woven material, and a laminate of a polyurethane foamand a polymer film.
 12. The tourniquet padding of claim 1, wherein thecover sheet comprises a breathable material.
 13. The tourniquet paddingof claim 1, wherein at least the outer surface of the cover sheetcomprises a liquid-repellent material.
 14. The tourniquet padding ofclaim 1, wherein the distal edge portion of the cover sheet comprisesperforations, slits, or a combination thereof, to separate the edgeportion into sections.
 15. The tourniquet padding of claim 1, furthercomprising a slip sheet releasably attached to the adhesive elements onthe cover sheet.
 16. The tourniquet padding of claim 1, wherein theproximal edge portion of the cover sheet is gathered.
 17. The tourniquetpadding of claim 16, wherein the proximal edge portion of the coversheet is pleated or crimped.
 18. The tourniquet padding of claim 16,wherein the cover sheet further comprises an elastic element attached tothe proximal edge portion.
 19. The tourniquet padding of claim 1,wherein at least one of the distal edge portion and the proximal edgeportion have a width sufficient for covering a tourniquet positionedover the padding material of the tourniquet padding.
 20. The tourniquetpadding of claim 1, further comprising an adhesive member for securingthe proximal and distal edge portions together.
 21. The tourniquetpadding of claim 1, further comprising one or more adhesive elementsattached to at least a portion of the outer surface of the cover sheet,the adhesive element having a length sufficient to be wrapped around anextremity of a person.
 22. The tourniquet padding of claim 1, whereinthe cover sheet comprises one or more perforated lines.
 23. Thetourniquet padding of claim 1, wherein the padding material comprisescast padding.
 24. The tourniquet padding of claim 1, wherein the paddingmaterial comprises a foam material.
 25. The tourniquet padding of claim1, wherein the cover sheet comprises a folded unitary sheet with thepadding material sandwiched therebetween.
 26. The tourniquet padding ofclaim 1, wherein the padding material comprises a porous material. 27.The tourniquet padding of claim 1, wherein the padding materialcomprises a natural material, a synthetic material, or a combinationthereof.
 28. The tourniquet padding of claim 1, wherein the paddingmaterial comprises a material selected from the group consisting ofcotton, nylon, rayon, acrylic, polyester, polyurethane, paper, andcombinations thereof.
 29. The tourniquet padding of claim 1, wherein thecover sheet comprises a material selected from the group consisting ofpaper, reinforced scrim material, crepe, cloth, terry cloth,cheesecloth, plastic, and combinations thereof.
 30. A tourniquetpadding, comprising: a single unitary cover sheet having an innersurface, an outer surface, a length, and opposing edges along thelength; the cover sheet comprising a polymer film material, and at leastthe outer surface of the cover sheet having a plurality of discrete andspaced apart adhesive elements with anti-slip properties situatedthereon; and a padding material situated on a portion of the innersurface of the cover sheet and extending the length of the cover sheetbetween said opposing edges, the padding material having a length andwidth sized for receiving a tourniquet thereon, and the cover sheetextending the length of the padding material; and the cover sheet havinga width sufficient such that with the tourniquet situated over thepadding material, the cover sheet can be placed to substantially coverthe tourniquet.
 31. The tourniquet padding of claim 30, wherein thecover sheet comprises a stretch cling plastic material.
 32. Thetourniquet padding of claim 30, wherein the polymer film material is abreathable material.
 33. A tourniquet padding, comprising: a singleunitary cover sheet having an inner surface, an outer surface, a length,and opposing edges along the length, the cover sheet comprising aplurality of spaced apart and discrete adhesive elements situated on theouter surface of the cover sheet to provide anti-slip properties, and anadhesive element on the inner surface along at least one of said edges;and a padding material situated on a portion of the inner surface of thecover sheet and extending the length of the cover sheet between saidopposing edges, the padding material having a length and width sized forreceiving a tourniquet thereon, and the cover sheet extending the lengthof the padding material; and the cover sheet having a width sufficientsuch that with the tourniquet situated over the padding material, thecover sheet can be placed to substantially cover the tourniquet withsaid opposing edges overlapped.
 34. The tourniquet padding of claim 33,wherein at least one of the adhesive elements is frictionally adhesive.35. The tourniquet padding of claim 33, wherein one or more adhesiveelements are attached to at least a portion of the outer surface of thecover sheet, the adhesive element having a length sufficient to bewrapped around an extremity of a person.
 36. The tourniquet padding ofclaim 35, wherein the second cover sheet can be frictionally adhered tothe skin of the person.
 37. A padding for a tourniquet, comprising: acover sheet comprising an inner surface and an outer surface, aplurality of spaced apart and discrete adhesive elements with anti-slipproperties situated on said outer surface of the plastic film layer; thecover sheet having a width such that a portion of the cover sheet may befolded over a distal edge of a tourniquet when situated on the coversheet; and a pad comprising a compressible material having memorysituated on the inner surface of the cover sheet, the pad having alength, and the cover sheet extending the length of the pad.
 38. Thetourniquet padding of claim 37, wherein the pad is adhesively attachedto the cover sheet.
 39. The tourniquet padding of claim 37, wherein whenthe padding is wrapped about and adhered to a limb of a person, at leastthe distal portion of the padding is not adhered to the limb and maylift upward when a tourniquet situated on the padding is inflated. 40.The padding of claim 37, wherein the pad is exposed on the surface ofthe cover sheet.